创伤性休克大鼠血浆内皮素与一氧化氮的动态变化及L-精氨酸治疗作用的实验研究

STUDY ON DYNAMIC CHANGES IN PLASMA NITRIC OXIDE AND ENDOTHELIN AND THERAPEUTIC EFFECT OF L-ARGININE ON TRAUMATIC SHOCK IN RATS

观察创伤性休克过程中血一氧化氮(NO)、内皮素 (ET)与组织氧分压的动态变化 ,探讨L 精氨酸对创伤性休克的治疗作用。采用下肢创伤法建立创伤性休克大鼠模型 ,随机分为休克组与处理组 ,观察创伤前后血NO、ET及骨骼肌、肝脏、小肠的组织氧分压的动态变化 ,监测血流动力学变化并记录存活时间。结果显示 ,创伤休克后血NO、ET浓度显著高于伤前水平 ,休克后组织氧分压较创伤前显著降低 ;处理组复苏后 5、12h血浆ET浓度显著低于休克组 ,复苏后各时间点血NO/ET值高于休克组 ,复苏后各时间点肝脏、小肠氧分压显著高于休克组 ,处理组 12、2 4h存活率显著高于休克组 (P<0 0 5 )。提示血NO、ET分泌紊乱及NO/ET的失衡在创伤性休克过程中有重要的意义 ,应用L 精氨酸可减少ET的分泌与释放 ,使NO/ET值升高 ,改善肝脏及小肠的氧分压 ,从而改善创伤性休克大鼠的预后。

The purpose of this study was to evaluate the dynamic changes in nitric oxide(NO), endothelin(ET) and oxygen partial pressure in tissues in the pathogenesis of traumatic shock, and to explore the therapeutic effect of L-Arginine. Traumatic shock was produced in Sprague-Daulay rats, and they were randomly divided into shock group and treatment group. NO and ET were assayed in blood, muscles, liver and small intestine before and after shock. Meanwhile, hemodynamic data of the rats and their survival time were monitored and recorded. The data showed that plasma NO and ET levels were elevated significantly after traumatic shock. There was statistical significance in tissues oxygen partial pressure between pretrauma and postshock periods. Plasma ET levels of treatment group at 5,12h after resuscitation were significant lower than that of shock group, and NO/ET were higher after resuscitation than that of shock group. Oxygen partial pressure in the liver and small intestine of treatment group were significant higher after resuscitation than that of shock group, and their survival rates at 12,24h were higher than that of shock group(P<0.05). The data suggested that disorder of NO/ET played an important role during traumatic shock. Supplementation of L-Arg could decrease plasma ET, raise NO/ET levels, improve oxygen partial pressure of internal organs and increase the survival rate significantly of the present traumatic shock model.